Papillary adenoma is one of the most common benign neoplasms of the gallbladder. In a study by Christensen and Ishak,128% of the 180 benign tumors were papillary adenoma. Other benign tumors include adenomatous hyperplasia, inflammatory pseudotumors, and gastric heterotopia. There is, however, to our knowledge, only 1 previous case report2of papillary adenoma of the cystic duct, which occurred in a 72-year-old woman who presented with a 3-month history of recurrent biliary colic. In our case, tarry stools in a teenager constituted the initial presenting symptom. Preoperative diagnosis was unlikely in both cases. The diagnoses were made only after examination of the resected specimens. In our patient, intraoperative findings showed regional lymphadenopathy near the common bile duct and a gallbladder and common bile duct of normal size. A frozen pathologic specimen of a sampled lymph node showed inflammation only. Malignancy could not be excluded. Cholecystectomy, resection of the common bile duct, lymph node dissection, and choledochojejunostomy with Roux-en-Y anastomosis were performed. Histologic examination confirmed a papillary adenoma. Our patient had an uneventful recovery.